6/11 Minnie PMPS 171

Discussion in 'Lantus / Levemir / Biosimilars' started by Liz & Minnie, Jun 11, 2021.

  1. Liz & Minnie

    Liz & Minnie Well-Known Member

    Joined:
    Feb 4, 2021
    previous post 6/5 https://felinediabetes.com/FDMB/thr...-2-220-4-181-6-200-9-238.248270/#post-2800210

    I haven't posted recently because not much to tell other than she is definitely still off - appetite is picky. Eating but I'm having to open lots of foods to get her to eat.

    IM just called back with urine culture and Minnie has 2 infections, 1 resistant ecoli and something else so orbax alone won't resolve. She suggests amikacin 10day course because it's injectable but stings (so need to dilute) and she has to be eating/hydrated because otherwise risk is kidney problems. Waiting to hear back if her colleague can fit her in today to give fluids and check blood gas to be sure this new a/b is ok.

    I didn't catch the other a/b she considered but rejected - chloronphetamil (? something like that) is a large pill that needs to be given for a long period, no good for Minnie. Nitro something, which can cause GI upset.

    ETA - found the other a/b she mentioned (and rejected for Minnie) here : Chloramphenicol and Nitrofurantoin
     
    Last edited: Jun 11, 2021
  2. tiffmaxee

    tiffmaxee Well-Known Member

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    Nov 15, 2013
    Is it amoxicillin? Never heard of amnikacin and can’t find it. I hope the two work quickly.
     
  3. Liz & Minnie

    Liz & Minnie Well-Known Member

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    Feb 4, 2021
    Last edited: Jun 11, 2021
  4. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Jun 4, 2020
    Overview of Amikacin for Dogs and Cats
    Brand Names and Other Names of Amikacin
    Uses of Amikacin for Dogs and Cats
    Precautions and Side Effects
    How Amikacin is Supplied
    Dosing Information of Amikacin for Dogs and Cats

    • Amikacin, commonly known by the brand name Amiglyde-V®, is a semi-synthetic antibiotic derived from kanamycin, a member of the aminoglycoside antibiotic family. This antibiotic acts on susceptible bacteria by inhibiting protein synthesis, resulting in bacterial cell death. Similar drugs include gentamicin, kanamycin and neomycin. It is used in dogs and cats to treat certain serious bacterial infections.
    • Amikacin is effective against specific bacteria and is not effective against fungi and viruses.
    • As with other aminoglycosides, amikacin is eliminated by the kidneys and has the potential to cause kidney damage.
    • Amikacin is a prescription drug and can only be obtained from a veterinarian or by prescription from a veterinarian.
    • This drug is registered for use in humans and animals.
    • Human formulations: Amikin® (Apothecon) and various generics
    • Veterinary formulations: Amiglyde-V® (Fort Dodge)
    • Amikacin is used to treat certain serious bacterial infections. It is not for use in routine infections due to potential toxicity.
    • While generally safe and effective when prescribed by a veterinarian, amikacin can cause side effects in some animals.
    • Amikacin should not be used in animals with known hypersensitivity or allergy to the drug.
    • Amikacin should be avoided in animals with kidney disease, dehydration and neuromuscular disease.
    • The drug should also be avoided in animals with fever or sepsis.
    • Due to potential toxicity, amikacin should be used with extreme caution in very young animals.
    • Amikacin has been reported to cause irreversible toxicity of the inner ear resulting in deafness. In addition, amikacin has also been reported to cause reversible kidney damage.
    • Amikacin may interact with other medications. Consult with your veterinarian to determine if other drugs your pet is receiving could interact with amikacin. Such drugs include furosemide, amphotericin B and certain antibiotics.
    • Despite the potential contraindications, amikacin is sometimes the only drug that is effective against certain bacterial infections. In these cases, the drug may have to be given despite potential complications.
    • Amikacin is available in injection form only. It is available in 50 mg/ml concentration in 50 ml vials. It is also available in 250 mg/ml concentration in 48 ml vials.
    • Medication should never be administered without first consulting your veterinarian.
    • If the medication must be given and any of the risk factors are present, use the smallest dose possible.
    • In dogs, the typical dose is 2.5 to 5 mg per pound (5 to 11 mg/kg) intravenous, intramuscular or subcutaneoulsy 2 to 3 times per day.
    • In cats, the typical dose is 2.5 to 5 mg per pound (5 to 11 mg/kg) intravenous, intramuscular or subcutaneoulsy 3 times per day.
    • The duration of administration depends on the condition being treated, response to the medication and the development of any adverse effects. Be certain to complete the prescription unless specifically directed by your veterinarian. Even if your pet feels better, the entire treatment plan should be completed to prevent relapse or prevent the development of resistance.
     
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  5. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Jun 4, 2020
    Poor Minnie. Did she tell you the name of the microbe that they cultured out of Minnie's urine (besides the e-coli). D-Mannose is a very helpful supplement for e coli infections. I wonder what in the world that bug is called?

    I'm worried about Minnie.

    Nitrofurantoin is an old drug that many of us are probably familiar with in human medicine -- it is commonly given for UTIs in people (that would work against the e coli.)
     
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  6. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Jun 4, 2020
    That drug sounds kind of scary :-( but most of them do sound scary when you read up on them, don't they? I'm just so worried about Minnie now!
     
  7. Liz & Minnie

    Liz & Minnie Well-Known Member

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    Feb 4, 2021
    I knew you'd know! Can't believe you are researching other kitties with all your own things going on. I'm a bit scared of it because vet actually pointed out the risk of kidney problems if they're deydrated/not eating - when I said Minnie hasn't been drinking for a long time now and I don't know if she's dehydrated (she's definitely not peeing as much), that's when she said to bring her in and get her blood checked and give fluids before starting it. And her kidney values were a little high last week.

    She didn't mention name of the microbe. Started the D-Mannose last week. Half wondered if that's what making her so finicky, her food now is mixed with potassium, spiro, D-mannose and Miralax - sometimes boulardii. But...she deigned to eat from the bowl when I held it to her mouth. Extreme breakfast in bed. I think she's laughing at me.
     
  8. FrostD

    FrostD Well-Known Member

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    May 27, 2020
    I can't remember, are you comfortable doing fluids at home? Maybe they can send you home with fluids to help ease your mind a bit?
     
  9. Liz & Minnie

    Liz & Minnie Well-Known Member

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    Feb 4, 2021
    Thanks, good thought. I haven't tried - had a 'lesson' after first failed attempt then she was in hospital for 3 weeks so I never needed to do it! I will ask, worth trying if they think she is dehydrated.
     
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  10. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

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    Sep 21, 2018
    :bighug::bighug::bighug: prayers for sweet Minnie
     
  11. tiffmaxee

    tiffmaxee Well-Known Member

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    Nov 15, 2013
    Definitely ask about giving fluids at home at least while on the antibiotics.
     
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  12. Purrberry

    Purrberry Member

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    Dec 11, 2020
    Wow...I'm usually up on my ABX, but that's one I haven't heard of! Sounds powerful but hopefully appropriate, as long as all the pre-treatment workups check out.

    If you proceed, I've read that refrigerating meds that tend to sting can lessen the stinging. But definitely check with your vet if that's something you could do. (I know they say it about injectable Cerenia) I am 100% on board with injectible meds these days!

    Paws crossed!!
     
  13. tiffmaxee

    tiffmaxee Well-Known Member

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    Nov 15, 2013
    @Purrberry I had never heard of this antibiotic either. That's why I asked if it was a typo.
     
  14. carfurby (GA)

    carfurby (GA) Well-Known Member

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    Feb 19, 2012
    Sending prayers. :bighug::bighug::bighug::bighug::bighug::bighug::bighug:
     
  15. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Jun 4, 2020
    I can’t help myself reading and researching when “our Minnie” is potentially going to take a new antibiotic that most of us here on the Board are not familiar with! I wonder why Minnie always has to have these exotic things going on? Poor Minnie and Poor Elizabeth!
     
  16. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Jun 4, 2020
    And if you proceed with it, you definitely need to make sure she is hydrated! Dehydration definitely can give worse kidney values in the bloodwork (I ought to know :-(. In other words that is probably why her kidney values were a little worse last week - dehydration. And why she should have a lot of fluids if she goes on this antibiotic.
     
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  17. Liz & Minnie

    Liz & Minnie Well-Known Member

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    Feb 4, 2021
    What about the other 2 (rejected) antibiotics, are those familiar? Chloramphenicol & Nitrofurantoin. The vet report didn't state the microbes, just said mixed UTI. I'm to dilute down the antibiotic to reduce stinging. She was 'very mildly dehydrated', they gave her 125mL SQ. I've updated her lab tab on the s/s. BUN is a bit higher, potassium dropping.

    Our vet was not there and they wouldn't/couldn't answer my questions so there's a note out for her to get back to me on whether I should give her fluids. They didn't send me home with any. Poor girl is washing herself a LOT down there since we got back so I know she's not well. I hope this wonderdrug acts quickly. I just realized that since previous blood work, vet reduced her potassium AND spiro so I think that's probably going to change when I talk to her.
     
  18. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Jun 4, 2020
    Chloramphenicol! Used to treat plague, meningitis, typhoid fever, cholera! Whoa. Another injectable. Can cause anemia/leukemia. I guess you don't get that one unless there's no other choice. Who knows how it works in cats... that's what they use it for in human medicine. In cats... you don't even want to read about the potential side effects but the severe anemia is one -- it messes with the bone marrow. I'm glad she's not getting that drug. Have you already started the injections? Just subcutaneous? Not IM?
     
  19. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Jun 4, 2020
    Just scanning the labs... her potassium needs to come up a bit, doesn't it. That's what you are saying about your vet probably increasing the spiro again (and K+ supplement?)

    It's interesting to see that her WBC has not been elevated although she has a confirmed UTI.
     

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